CPT® Code 22526

Percutaneous intradiscal electrothermal annuloplasty is a minimally invasive procedure designed to alleviate chronic low back pain associated with disc pathology. This technique utilizes a catheter-based approach, allowing for targeted treatment of the affected intervertebral disc. Initially, the specific disc requiring intervention is identified through a process known as discography, which helps to confirm the source of pain. A specialized spinal catheter, equipped with a thermal resistive coil, is then carefully inserted into the disc annulus or nucleus. The catheter is maneuvered through the disc in a circuit-like fashion, exiting posteriorly. Once positioned correctly, the thermal coil generates electrothermal heat, which is applied to the disc material for approximately 20 minutes at a controlled temperature of 90 degrees centigrade. Importantly, this heating process does not result in tissue destruction, burning, or ablation. Instead, the application of heat is believed to provide pain relief by causing the collagen fibers within the disc to shrink and by thermocoagulating the adjacent nerve tissue or pain receptors. This procedure is reported using CPT® Code 22526 for a single level, whether performed unilaterally or bilaterally, with fluoroscopic guidance included as part of the process.